Training primary care professionals in multimorbidity management: Educational assessment of the eMULTIPAP course.

Multimorbidity (MM) is a widespread problem and it poses unsolved issues like the healthcare professionals' training. A training curriculum has been proposed, but it has not been sufficiently explored in a clinical context. The eMULTIPAP course is part of the MULTIPAP complex intervention, applied through a pragmatic controlled, cluster randomized clinical trial to general practitioners (GP) and his/her patients with MM with 12 months follow-up. The eMULTIPAP course is based on problem-based learning, constructivism and Ariadne principles. It has been assessed according to the Kirkpatrick model and has shown knowledge improvement and high applicability of learning with more motivation to consider MM in the clinical practice. It has also improved the Medication Appropriateness Index at 6-months and at 12- months. We conclude that the eMULTIPAP course generates significant changes in GP's learning, enhancing clinical practice in multimorbidity scenarios.

Obesidad y factores de riesgo cardiovascular en adolescentes. Asociación con factores de riesgo cardiovascular en familiares de primer grado / Obesity and cardiovascular risk factors in adolescents. Association with cardiovascular risk factors in first degree relatives

Fundamento y objetivo: La obesidad es uno de los principales problemas de salud pública. En la adolescencia existe una falta de contacto con el sistema sanitario que impide realizar un diagnóstico de la misma y de la morbilidad que asocia. El objetivo del presente estudio es conocer a los 18 años la prevalencia de obesidad, sobrepeso, factores de riesgo cardiovascular (FRCV) y su posible asociación con existencia de FRCV en padres y hermanos. Pacientes y método: Se realiza un estudio de 153 niños seguidos hasta los 18 años en un centro de salud, determinando índice de masa corporal (IMC), perímetro de cintura, FRCV y antecedentes familiares. Resultados: La prevalencia de obesidad es del 7,18% (intervalo de confianza del 95% [IC 95%] 3,0-11,0) (6,25% en varones y 7,86% en mujeres) y la de sobrepeso del 18,3% (IC 95% 11,9-24,0) (26,56% en varones y 12,35% en mujeres). Refieren antecedentes familiares de FRCV un 53,9% (IC 95% 46,1-61,9) de los casos: hipertensión arterial (25%), obesidad (23,6%), dislipidemia (21,7%) y diabetes (7,2%), globalmente más frecuentes (72,72%) en el grupo de obesidad que en el de sobrepeso (64,2%) y normopeso (49,59%). Existe asociación entre obesidad a los 18 años y obesidad y diabetes en sus familiares de primer grado, así como entre hipertensión arterial a dicha edad e hipertensión arterial en familiares de primer grado. Conclusiones: Con el fin de diagnosticar en jóvenes adultos situaciones de obesidad, sobrepeso y posibles complicaciones a ellas asociadas se debe realizar un seguimiento especial a hijos de padres y hermanos de personas con factores de riesgo, fundamentalmente hipertensos, diabéticos y obesos

Background and objetive: Obesity is a major concern in public health. The fact that most teenagers stop contacting the health system during this period of life prevents detection of this problem and its associated morbidity. The aim of this study is to measure the prevalence of obesity at 18. We also aimed to detect overweight, cardiovascular risk factors (CVRF) and association with CVRF in parents and siblings. Patients and method: The research includes 153 children followed up to 18years old in a community health center. Measures of body mass index (BMI), waist perimeter, CVRF, and familiar history were taken. Results: The prevalence of obesity in our study group was 7.18%, (IC: 3.0-11.0), (6.25% male and 7.86% female). The prevalence of overweight was 18.3% (IC: 11.9-24.0), (26.56% male and 12.35% female). A familiy history of CVRF was found in 53.9% (IC: 46.1-61.9) of cases, including high blood pressure (25%), obesity (23.6%), dyslipemia (21.7%), and diabetes (7.2%). This finding was more prevalent in the obesity group (72.72%) than in those with overweight only (64.2%), or with normal weight (49.59%). A family history of obesity and diabetes in first-degree relatives was associated to obesity in the study group. Also, a family history of high blood pressure was associated to the presence of high blood pressure in this group. Conclusions: In order to detect obesity, overweight, and associated complications in young adults, specific attention to children and siblings of persons who present risk factors is recommended. Those with high blood pressure, diabetes or obesity have the higher risk (AU)

[Obesity and cardiovascular risk factors in adolescents. Association with cardiovascular risk factors in first degree relatives]. / Obesidad y factores de riesgo cardiovascular en adolescentes. Asociación con factores de riesgo cardiovascular en familiares de primer grado.

BACKGROUND AND OBJECTIVE: Obesity is a major concern in public health. The fact that most teenagers stop contacting the health system during this period of life prevents detection of this problem and its associated morbidity. The aim of this study is to measure the prevalence of obesity at 18. We also aimed to detect overweight, cardiovascular risk factors (CVRF) and association with CVRF in parents and siblings. PATIENTS AND METHOD: The research includes 153 children followed up to 18 years old in a community health center. Measures of body mass index (BMI), waist perimeter, CVRF, and familiar history were taken. RESULTS: The prevalence of obesity in our study group was 7.18%, (IC: 3.0-11.0), (6.25% male and 7.86% female). The prevalence of overweight was 18.3% (IC: 11.9-24.0), (26.56% male and 12.35% female). A familiy history of CVRF was found in 53.9% (IC: 46.1-61.9) of cases, including high blood pressure (25%), obesity (23.6%), dyslipemia (21.7%), and diabetes (7.2%). This finding was more prevalent in the obesity group (72.72%) than in those with overweight only (64.2%), or with normal weight (49.59%). A family history of obesity and diabetes in first-degree relatives was associated to obesity in the study group. Also, a family history of high blood pressure was associated to the presence of high blood pressure in this group. CONCLUSIONS: In order to detect obesity, overweight, and associated complications in young adults, specific attention to children and siblings of persons who present risk factors is recommended. Those with high blood pressure, diabetes or obesity have the higher risk.